Paget’s disease (a bone disorder), surgery or injury, and a joint infection. Osteoarthritis of the hands tends to run in families. In the fingers, osteoarthritis commonly affects the first joint below the fingertip, forming calcific spurs known as Heberden’s nodes , or on the fingers’ middle joints, where the bone spur is called a Bouchard’s node. The base of the thumb joint also is commonly affected by osteoarthritis. Osteoarthritis of the spine may affect the cartilage in the disks, the moving joints of the spine itself, or both. Osteoarthritis in the shoulder can develop in the shoulder joint itself (the glenohumeral joint) or in the acromioclavicular joint between the shoulder blade and the collarbone. Diagnosis and symptoms No single test can diagnose osteoarthritis. Instead, clinicians use a variety of examinations and diagnostic tests to establish a diagnosis. These include a physical exam to check for tenderness, warmth, stiffness or fluid in a joint; the medical histories of the individual and his or her family; blood and urine tests; and imaging tests. Osteoarthritis is characterized by pain, stiffness, loss of mobility and swelling of the tissues around a joint. The pain is usually a dull, aching pain, although a sharp pain may occur with sudden movements. Some people experience muscle spasm and contractions in the tendons. Although these symptoms can occur in any joint, they most commonly affect the knees, hips, and joints in the hand and lower back. Most commonly the joint pain worsens during activity and gets better during rest. Stiffness also tends to follow periods of inactivity, such as sleep or sitting. The stiffness can last for more than an hour and can usually be eased by stretching and exercise. As the disease advances, the pain may occur even when the joint is at rest and can keep a sufferer awake at night. Individuals with osteoarthritis often report that the pain increases in humid weather. With osteoarthritis of the knee, pain is usually felt in the inside part of the knee, but it also may be felt in the front or back of the knee. Although painful, the arthritic knee usually retains reasonable flexibility. Osteoarthritis in the knee may cause a crackling like noise (crepitus) when moved. Risk factors The following are the primary factors that increase the risk of developing osteoarthritis: ● Age: Those 45 years old or older are more likely to have osteoarthritis, and the prevalence increases as people age. ● Gender: More women have osteoarthritis than men. ● Genetics: Having certain hereditary conditions, including defective cartilage and malformed joints, can cause osteoarthritis. In addition, researchers report a correlation of osteoarthritis between parents and children. Scientists are studying a number of genes that might contribute to an inherited risk. ● Overweight and obesity: Being overweight puts extra strain on the joints, particularly the large weight-bearing joints, such as the knees and hips. 4, 5 Osteoarthritis of the knee is about four to five times more prevalent in obese men and women than in people at normal weight. 4 ● Geography: Prevalence of osteoarthritis varies widely among geographic regions. In the United States, the rates in adults are lowest (34 percent) in Hawaii and highest (70 percent) in Alabama. In general, the highest prevalence occurs in the central and northwestern states. 2
Figure 2: Joint with Severe Osteoarthritis
Illustration Sources: National Institute of Arthritis and Musculoskeletal and Skin Diseases
Pain develops slowly with osteoarthritis of the hips, usually in the groin and on the outside of the hips or sometimes in the buttocks. The pain also may radiate to the knee, which can confuse the diagnosis. Individuals with osteoarthritis of the hip often have a restricted range of motion and walk with a limp, because they slightly turn the affected leg to avoid pain. Osteoarthritis of the spine can cause pain in the area of the affected disks, muscle spasms and diminished mobility. In some cases, the nerves may become pinched, a condition that also produces pain. Advanced disease may lead to numbness and muscle weakness. When osteoarthritis of the spine occurs in the neck, it can cause difficulty in swallowing. Osteoarthritis in the shoulder is less common than in other joints. When it develops in the glenohumeral joint, it is most often associated with a previous injury, and patients gradually develop pain and stiffness in the back of the shoulder. Osteoarthritis in the acromioclavicular joint rarely causes symptoms. Fatigue and general weakness are not signs of osteoarthritis. Individuals with osteoarthritis of the knees may have impaired ability to perform activities of daily living, such as walking, bathing, dressing and performing household chores. In addition to physical symptoms, osteoarthritis can have lifestyle and financial effects, including depression, anxiety, the cost of treatment, and lost wages. ● Joint injuries: A traumatic injury or abrupt impact can trigger osteoarthritis. Thus, falls, car accidents and sports injuries are often implicated in the onset of osteoarthritis. ● Certain diseases: Diseases that change the normal structure and function of cartilage, such as rheumatoid arthritis or hemochromatosis (an iron overload disease), can lead to osteoarthritis. ● Malaligned bones: Being knock-kneed or bowlegged increases the chances for wear and tear in the joint, leading to osteoarthritis. ● Weak quadriceps: A research study concluded that quadriceps weakness may be a cause for the development of osteoarthritis. 5 Of these risk factors, being overweight is one of the most significant, and one that lends itself to prevention. If an individual is overweight or obese, the best way to reduce the risk of developing symptoms of osteoarthritis is to lose weight. Studies have shown that overweight or obese women who lose just 11 pounds decrease their risk of osteoarthritis by about 50 percent. 6
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